MEDICARE: KALI HENRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	4704384353	MI

General Provider Information

NPI Number	:	1083451769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALI HENRY

Provider Business Mailing Address
First Line	:	2515 WARWICK DR
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48304-1856
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2515 WARWICK DR
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48304-1856
Country	:	US
Telephone Number	:	906-241-2929
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2024
Last Update Date	:	07/10/2024

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Directions to “ KALI HENRY ” Practice Location

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